| NPI | 1033291190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 203488) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101239433) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2021-03-31 |